[Reoperations after total alloarthroplasty of the hip (author's transl)]

Results of alloarthroplasty of the hip joint

We report on the follow-up examination results of 881 operated hip joints which were implanted in the Innsbruck University Clinic for Orthopedics during the period 1968--1975. Due to exact checking 75% of all patients could be clinically control-examined during 1978 and all available information regarding the others was collected. In the patient group with an average age of 62.5 years the course of postoperative mobility over the years was mainly examined. Functional activity, subjective patient opinion, pain, work capability and weather sensitivity were also analyzed. After an implantation period of the hip prosthesis of 3--10 years encouraging results were shown. Aseptic prostheses loosenings (9.8%) were examined with regard to their causes. The infection rate was very low at 0.56% and also periarticular calcification only occurred comparatively seldom (13.5%). Other complications were recorded in 6.8% of the patients. In total, 74% of the operated patients offered a very good or good complete result.

[Complications after total hip endoprosthesis: fracture of the femur and simultaneous fracture of the cement mount of the acetabulum (author's transl)]

Report about a rare complication after total hip endoprosthesis with a simultaneous rupture of the cement mount in the acetabulum (due to a trauma) and a fracture of the femur. The x-rays and the intraoperative findings were interpreted erroneously; therefore the diagnosis was delayed. A second operation was needed to reimplant the acetabulum. During the same operation a wrong position of the prosthesis (outward rotation) had to be corrected.

[Fractures of the femural shaft following trepanation of the corticalis and how to avoid it. At the same time an article on changing hip endoprothesis (author's transl)]

The problem of trepanation of the corticalis is investigated in 2 cases of femoral shaft fractures following a lateral trepanation of the femur, which can very often not be avoided in performing a necessary change of the hip prothesis. It can be demonstrated that because of the stress on the femur and its mechanical characteristics (material distribution, density distribution, breaking strength, "structure" strength and the histological structure), a lateral trepanation of the femoral corticalis is weakening the bone in its mechanically most stressed part whereas an anterior fenestration is mechanically much better. Considering the distribution of the strain in differently formed notches with rapid increase of strain with local rigidity in a pointed notch a mechanically much better rounding of the notch is suggested.

Antibiotic prophylaxis in allo-arthroplastic hip joint surgery. Concentration assays in the wound exudate after parenteral administration of gentamicin

The indecation and the efficacy of antibiotic prophylaxis in endoprosthetic operations are discussed with reference to prospective studies. After parenteral administration of 80 mg gentamicin the antibiotic concentrations in the serum and in the wound exudate were studied for 2 to 6 hrs after administration. During this observation period the gentamicin concentrations in the wound exudate were about equal to those in the serum. A comparison of the concentrations after parenteral and after local administration of gentamicin showed much higher concentrations in the wound exudate when gentamicin was administered with the bone cement.